Document Detail

Avoidance of embolic complications by ultrasonic characterization of the ascending aorta.
MedLine Citation:
PMID:  2670329     Owner:  NLM     Status:  MEDLINE    
Surgical manipulation of the atherosclerotic ascending aorta in elderly patients is often accompanied by serious complications. To reduce the risk of disrupting highly degenerated but nonpalpable plaques, we used quantitative ultrasonic techniques to intraoperatively image the ascending aorta in 33 patients (mean age, 71 years) as a guide to selection of cross-clamping or cannulation sites. Two-dimensional, integrated backscatter images (integration time, 1.6 mu sec) were obtained with a 5-MHz transducer wrapped in a sterile sheath and placed directly on the aorta. Significant atherosclerotic disease was detected in 18 patients. Calcified lesions were found in 13 patients, and fibrofatty lesions were found in five. In four patients undergoing repair of degenerative aneurysms, the extent and distribution of ultrasonically delineated regions of calcification and fibrosis were confirmed histologically. In eight (24%) patients, the composition, severity, and location of plaques delineated ultrasonically led to selection of alternate cannulation sites without resultant atheroembolism. Thus, ultrasonic tissue characterization sensitively delineates the extent of aortic atherosclerosis, and its use may decrease the risk of atheroembolism.
B Barzilai; W G Marshall; J E Saffitz; N Kouchoukos
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  80     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-10-11     Completed Date:  1989-10-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  I275-9     Citation Subset:  AIM; IM    
Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri 63110.
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MeSH Terms
Aged, 80 and over
Aorta / pathology*
Aortic Diseases / complications,  diagnosis,  surgery
Aortic Valve
Arteriosclerosis / complications,  diagnosis,  surgery
Calcinosis / complications,  diagnosis,  surgery
Coronary Artery Bypass
Heart Valve Prosthesis
Intracranial Embolism and Thrombosis / etiology,  prevention & control*
Intraoperative Care / methods
Intraoperative Complications / etiology,  prevention & control*
Middle Aged
Mitral Valve
Ultrasonography / instrumentation,  methods*
Grant Support

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